This proposal is an application for a Medicare Investigator Award in Patient-Oriented Research in Skin Diseases for Mary-Margaret Chren, MD. Dr. Chren is an internist, dermatologist, and clinical epidemiologist who is currently Associate Professor in Residence, University of California at San Francisco (UCSF). Dr. Chren's career aims are (1) to perform rigorous patient-based studies to understand, measure, and improve the health of patients with chronic diseases, using skin diseases as a model of conditions that affect myriad domains of health, and (2) to use her research as a medium to mentor beginning investigators in patient oriented research in skin diseases. The purpose of this application is to increase Dr. Chren's scholarly potential and contribution in each of these domains. The application describes a Research Plan that will build on Dr. Chren's current research and will examine the course of treated nonmelanoma skin cancer (NMSC), the most frequent malignancy. Specifically, the research will follow the NMSC Cohort, a consecutive cohort of over 1500 patients with newly diagnosed NMSC that Dr. Chren assembled in 1999 and 2000. Substantial baseline data about the patients, tumors, and treatments were collected. Tumor recurrence and skin-related quality of life will be determined at five years after therapy, to compare effectiveness of the major types of therapy. The application also describes a Mentoring Plan for beginning investigators that has three parts: didactic curricula, "hands-on" research experience, and career development. Didactic curricula are integrated with UCSF's exemplary clinical research training programs, including the Training in Clinical Research curriculum through the K30 award. Practical research experience will be obtained by working directly with Dr. Chren and her colleagues on datasets she has established (including the NMSC Cohort described above) and on newly collected data. The Mentoring Plan, aimed at dermatology residents, fellows, and faculty, and medical students, can be tailored to the capacity of mentees to commit time to research career development. Together, the Research Plan and the Mentoring Plan provide a five-year strategy that will permit Dr. Chren to broaden the scope of her on-going research as well as formalize an explicit mentoring arrangement for developing new patient-oriented investigators in skin diseases.